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Biomedical subjects

R Harzmann

Publications and source records attributed to R Harzmann.

At least 19 recordsLinked to original sources
PubMed1992

[Evaluation of new technical alternative procedures for therapy of symptomatic benign prostatic hyperplasia].

Transurethral resection of the prostate is still the gold standard in the treatment of symptomatic benign prostatic hyperplasia. It has proved possible to reduce the mortality of this treatment almost to zero, while the morbidity has remained unchanged at 18% for decades. Therefore, understandably, procedures are being looked for that will be similarly effective but have lower morbidity. Current developments in this field are transurethral implants (spiral, intraurethral catheter, Wall-Stent), the balloon dilatation, transurethral incision (TUIP), laser therapy (TULIP, ITK), ultrasound-induced aspiration of tissue and heat treatment (hyperthermia, thermotherapy). Chances and risks inherent in these different technical procedures and the amount of investment they involve are reviewed. Potential for the future can at best be attributed to the Wall-Stent, TUIP, the application of laser and the thermotherapy.

Catheterization↗
PubMed1990

Importance of Doppler sonography in urology.

There have been major advances in Doppler technology over the last 5 years which are particularly useful in the field of urology. In the early 1980s the clinical significance of Doppler was limited to the diagnosis of testicular torsion and its use was primarily intraoperative. Today, however, new advances, i.e. pulsed Doppler, duplex sonography, and color-coded duplex sonography (angiodynography), have cleared the way for totally new approaches to vascular impotence, renal artery stenosis, renal artery embolus, intratumor flow measurement, and control of renal transplants. These new technical advances will be exemplified in typical pathological states.

Blood Flow Velocity↗
PubMed1989

Retroperitoneal lymph nodal visualization using 30% Guajazulen blue (chromolymphography).

Guajazulen, a dark blue lipid-soluble dye was used to stain retroperitoneal lymph nodes before lymphadenectomy. Initially, a 30% solution of Guajazulen (Merck, Darmstadt, FRG) in iodinated oil (Lipiodol, Byk-Gulden, Konstant, FRG) was injected endolymphatically in the hindlimbs of pigs (n = 10) and dogs (n = 8) to better visualize retroperitoneal lymph nodes. Because of encouraging results, 11 patients with testicular cancer undergoing staging or therapeutic laparotomy underwent endolymphatic injection of this dye solution preoperatively. The excellent staining of retroperitoneal lymph nodes facilitated nodal selectivity during lymphadenectomy.

Animals↗
PubMed1988

Clinical experience with an alloplastic stoma prosthesis (Biocarbon) for urinary conduits and cutaneous ureterostomy.

An alloplastic stoma prosthesis, Biocarbon, composed of 99.9% pure carbon in vitreous form, was used in six patients with conduit urinary diversion and in seven with cutaneous ureterostomy. The patients were thereafter observed for 2-86 months. Complications were subcutaneous infection, urinary fistula and ureteral stenosis, which necessitated removal of the prosthesis in most cases. The permanent stoma, without need for adhesive collecting device, was appreciated by the patients. Problems relating to biocompatibility remain to be solved before the place of the stoma prosthesis in urinary diversion can be determined.

Carbon↗
PubMed1988

Patent blue V encapsulation in liposomes: potential applicability to endolympatic therapy and preoperative chromolymphography.

The water soluble dark blue stain Patent Blue V was incorporated into liposomes to increase its depot properties. Experiments with intraperitoneal and intramuscular application in rats and with intralymphatic injections in rabbits showed a substantial difference between the pharmacokinetics of aqueous and liposomal solutions. Independent of the route of administration, the dye-stain remained much longer in the tissues using liposomes. Most notably, retroperitoneal lymph nodes in rabbits remained dark blue up to 28 days after hindlimb endolymphatic instillation of liposomal patent blue. This vastly superior depot effect may be clinically adaptable for endolymphatic therapy with cytostatic drugs to enhance nodal drug retention and concentration or for preoperative chromolymphography to facilitate nodal visualization at laparotomy.

Animals↗
PubMed1988

[Stage-adapted pain therapy in advanced malignant urologic diseases].

In advanced urological malignant diseases pain therapy is frequently of prime importance. Considerable progress in this area has led to the treatment of pain being taken on increasingly by specialized groups, in some cases without feedback to the urologist. In this situation it seems expedient for a urologist working in the field of oncology to be thoroughly informed of the present status of knowledge in modern pain treatment. The opportunities opened up by interdisciplinary team work directed by a urologist are pointed out, as are the requirements this imposes. The current chances of medicamentous cancer pain therapy and the treatment options in the fields of anaesthesiology, neurology and neurosurgery are touched upon with reference to the pathophysiology of chronic painful conditions.

Analgesics↗
PubMed1987

[Early diagnosis of urogenital tumors].

The early diagnosis of primary urogenital tumors shows varying efficacy regarding the various tumor types. While the urothelial tumors of the renal pelvis, the ureter and the bladder reveal early symptoms such as hematuria hypernephroma, urethral carcinoma and carcinomas of the prostate and the testes remain clinically silent for a long time. Thus early diagnosis of carcinomas of the prostate or the testes might only be made by palpation at best. Aside from cytologic examination of the urinary tract, there are no other laboratory techniques at hand to give clear evidence of early tumor stages. The possibilities of early recognition of hypernephroma, carcinomas of the renal pelvis, ureter, bladder, or urethra, and carcinomas of the penis, testes, and prostate are demonstrated and compared with each other in respect of their specificity.

Carcinoma, Renal Cell↗
PubMed1987

[Stress sonography of the lower urinary tract].

Mild caliectasis in patients with occult ureteropelvic obstruction can cause difficulties in the decision on operative or non-operative measures. In such situations diuresis renography, diuretic radionuclide urography and perfusion pressure flow studies (Whitaker test) can be very useful. Furosemide-sonography is a new, non-invasive method demonstrating functional subpelvic obstruction. Standardised conditions before and after application of furosemide are necessary. This new diagnostic method is demonstrated based on a evaluation in 22 patients presenting radiological evidence of minor ureteropelvic obstruction.

Female↗
PubMed1986

[Ultrasound-controlled percutaneous kidney biopsy].

Nephrological diseases--in special cases also unsettled forms of microhematuria--require a biopsy of the kidney. To date this intervention has mostly been performed under x-ray control by means of the Menghini or the Trucut-needle. Ultrasound opened up new perspectives, particularly after the introduction of perforated ultrasound probes. These ensure complete control of the intervention provided that appropriate puncture systems are applied. The cut biopsy needle (Otto) offers great advantages because it is thinner than the puncture systems used so far. With identical quality of the cast compared to that obtained with conventional techniques, the needle recommended is less traumatic and hence both risk and patient discomfort are reduced. Report on 52 punctures.

Biopsy, Needle↗
PubMed1986

Experimental studies on therapy of metabolic alkalosis during the beginning of uremia. Influences of ammonium chloride on the intra- and extracellular acid-base status of the rat.

Metabolic alkalosis during renal failure or uremia presents a difficult problem for the clinician. In this study the effects of ammonium chloride, an agent clinically used for the correction of severe metabolic alkalosis, were studied on the extra- and intracellular acid-base balance of nephrectomized rats. While the extracellular acid-base status was determined from blood gas measurements, intracellular pH was calculated from the distribution of 5,5-dimethyl-2,4-oxazolidinedione. It was found that the administration of NH4Cl leads to a significant increase of intracellular pH though extracellular plasma pH decreases, and that ammonium chloride causes only an insignificant reduction of the intracellular bicarbonate concentration. The observed intracellular pH increase may have adverse consequences for patients and raises objections to the further use of ammonium chloride in the treatment of metabolic alkalosis, especially during renal failure or uremia.

Acid-Base Equilibrium↗
PubMed1986

[Cancer induction by urinary drainage or diversion through intestinal segments?].

Since the introduction of ureterosigmoidostomy 79 cases of adenocarcinomas of the sigmoid near the implantation site of the ureters were described. Clinical and experimental data indicate that the excretion of urine and faeces together leads to endogenous nitrosamine synthesis and thus induces carcinomas. Other factors--like carcinogens excreted with the urine or chronic irritation of the mucosa by urine--could also cause carcinomas in the urine diverting parts of the intestine. Based on our own cases and a study of the literature we investigated whether other forms of urinary diversion can induce tumors. So far 4 tumor cases in ileum conduits and 2 cases in colon conduits have been reported together with 2 tumors in bladder augmentation (ileocystoplasty). We found in our material 1 case of cancer in a rectum bladder, 1 in a colocystoplasty, and 2 after ureterosigmoidostomy. In ureter substitution plasty and following Kock- or Camey-technique no cases of tumor induction have been reported so far. From the presently available data it must be concluded that urinary diversion using intestine may cause tumor induction. With the interval between surgery and evidence of tumor being at least 20 years a sharp increase in morbidity must be expected for the years after 1990. This leads to the demand that all patients with urinary diversion using intestine must be regularly evaluated by radiological, endoscopic and bioptic controls. These oncological aspects should be considered for the appropriate choice of urinary diversion especially in children.

Humans↗
PubMed1985

[Experimental studies on hemolysis in transurethral interventions].

The question whether distilled water can be used as irrigating fluid for the transurethral electroresection has repeatedly given occasion for discussion. Price and better visibility when resecting speak in favour of its application. Haemolytic alterations, however, might occur and seem to make its application dangerous. Our own experiments in animals show that especially blood haemolised through distilled water in the bladder (a mixture of aqua dest. and haemolised erythrocytes) has a strong haemolytic effect. Intravenous instillation of distilled water leads to haemolytic processes as well, which, however, are weaker than those occurring after instillation of erythrocytes haemolised through distilled water. Solutions of Sorbitol and Manitol (e.g. Purisole) had no measurable haemolytic effect. On the basis of our examinations we can retain the fact that with massive absorption of already haemolised erythrocytes, dangerous alterations, occur. Such alterations depend on duration of resection, technique of resection and pressure conditions (use of low pressure irrigation resectoscopes or trocar irrigation). For the experienced urologic surgeon these factors might be less relevant, for the beginner, however, who might not take into consideration the facts mentioned, results could be disastrous. The use of Sorbitol- and Manitol-fluids during TUR, prevents haemolytic incidents with certainty.

Animals↗
PubMed1979

[Carbon polymer stomata in vesicostomy and other urinary diversion procedures (author's transl)].

Implants of pure carbon are ideal for prosteses because of their tissue acceptability and lack of incrustation. Animal experiments with biocarbon implants were tested as subfascial implantations, coeco-, ileo-, and vesicostomies, (n = 37). The results showed lack of reaction and good healing of the stomata, lack of incrustation, and water tight urinary diversion. Based on these animal experiments biocarbon vesicostomies were carried out successfully in six patients. The follow up period was 3--16 months.

Animals↗